Tags: Digestive Problems | crohn | colitis | new | treatment

New Help for Those With Crohn's, Colitis

Monday, 02 June 2014 04:19 PM

Not long ago, patients with Crohn's disease and ulcerative colitis typically underwent surgical removal of the inflamed colon to ease painful abdominal cramps, persistent diarrhea, fatigue, nausea, and the depression and anxiety that can accompany these symptoms.
But now, when people with chronically inflamed bowels have surgery, it is nearly always less aggressive, rarely requiring an external pouch to replace a surgically removed colon and rectum, The New York Times reports. 
A variety of other new treatment approaches are offering new options to patients with inflammatory bowel diseases that afflict 1.4 million Americans. Experts say therapies for these chronic conditions are being transformed, spurred by the decoding of the human genome and a growing understanding of the balance of microbes in the gut.
In the 98 percent of patients with ulcerative colitis in whom the colon must be removed, for instance, it is replaced by an internal pouch — not an external bag — used as a reservoir for stool that is sutured directly to the rectal canal, said Balfour Sartor, M.D., chief medical adviser to the Crohn's and Colitis Foundation of America.
As with operative changes for ulcerative colitis, surgery for Crohn's disease has become less disruptive of normal digestive function in recent years. Instead of removing diseased sections of the intestine, Crohn's patients can have a procedure called strictureplasty, better preserving the body's ability to absorb nutrients.
"Surgery doesn't cure Crohn's," Dr. Sartor said, "but this technique preserves most of the natural function of the small intestine, where nutrients are absorbed."
Meanwhile, improved medical remedies are fast emerging. Experts are working on treatments based on a patient's genetic makeup, an approach now increasingly used to treat cancer.
A new understanding of how environmental factors like diet and antibiotics can disrupt the balance of microbes in the gut is also being translated into new treatments. Some bacteria are protective and keep the gut healthy, while others result in chronic inflammation.
Another new approach aims at gut-specific transport of inflammatory cells from the blood into the intestines. The Food and Drug Administration just approved a drug called vedolizumab, which blocks the movement of those cells.
"This is a completely new strategy for treating Crohn's and ulcerative colitis," said James D. Lewis, M.D., professor in the gastroenterology division at the University of Pennsylvania Perelman School of Medicine.
Perhaps most important for people with an inflammatory bowel disease, Dr. Scherl said, is to be cared for by a specialist "who understands its complexities and nuances and listens to patients who are living with it."


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Not long ago, patients with inflammatory bowel disease - Crohn's and ulcerative colitis - typically underwent surgical removal of the inflamed colon to ease painful symptoms. But new approaches to treating the digestive disorders are helping patients.
crohn, colitis, new, treatment
Monday, 02 June 2014 04:19 PM
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